slide1 n.
Download
Skip this Video
Download Presentation
Emmanuel Njeuhmeli, MD, MPH, MBA Senior Biomedical Prevention Advisor, USAID Washington

Loading in 2 Seconds...

play fullscreen
1 / 14

Emmanuel Njeuhmeli, MD, MPH, MBA Senior Biomedical Prevention Advisor, USAID Washington - PowerPoint PPT Presentation


  • 69 Views
  • Uploaded on

Thinking Ahead: Voluntary Medical Male Circumcision Roll-Out With Non Surgical Devices: costing, global access, logistic, and training considerations. Emmanuel Njeuhmeli, MD, MPH, MBA Senior Biomedical Prevention Advisor, USAID Washington

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Emmanuel Njeuhmeli, MD, MPH, MBA Senior Biomedical Prevention Advisor, USAID Washington' - ricky


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Thinking Ahead: Voluntary Medical Male Circumcision Roll-Out With Non Surgical Devices: costing, global access, logistic, and training considerations

Emmanuel Njeuhmeli, MD, MPH, MBA

Senior Biomedical Prevention Advisor, USAID Washington

Co-Chair PEPFAR Male Circumcision Technical Working group

voluntary medical male circumcision
Voluntary Medical Male Circumcision…
  • Effective, safe, feasible and affordable HIV prevention intervention for countries with high HIV prevalence, low MC prevalence
  • Will generate substantial cost savings in the next 5 years if roll-out reaches maximum coverage possible
    • “every dollars spend on AIDS is an investment, not an expenditure” Michel Sidibe, Executive Director UNAIDS
strategy for achieving pace and scale
Strategy for Achieving Pace and Scale
  • Political will and country ownership
  • Strong leadership and coordination from MOH
  • Effective communication strategy with strong community level buy-in
  • Enough financial resources for service delivery including some level of dedication of staff time, facilities space and commodities
    • Donor commitment
  • Excellent technical support from partners to allow a good match of demand and supply for efficient use of limited resources available to reach maximum number of men
  • Flexibility to adopt innovations as they become available --- non surgical devices
costing study research q uestions
Costing Study Research Questions
  • Unit costs of
    • surgery-only (forceps-guided, reusable kits)
    • mixed (forceps-guided surgery and PrePex)
  • Cost drivers
  • Cost impact
    • % site capacity used
    • ratio of surgery vs. device-based circumcisions at mixed site
    • range of device prices
  • Next step: additional scenario w/ Shang Ring
cost categories
Cost Categories
  • Staff
  • Training
  • Consumables
  • Device
  • Durable equipment
  • Supply chain management
  • Waste management
caveats
Caveats
  • Not possible to obtain actual costs for device under scale-up situation; costs were obtained from pilot field study
  • If data were available the modeling exercise would not be needed

Assumptions;

  • Indirect costs not included for all scenarios
  • Many costs will be higher if circumcisions are conducted in dedicated facilities rather than integrated into public facilities
  • Analysis did not look at effects of task shifting for the surgery
  • Analysis did not look at greater number of circumcisions/day with device
  • Acceptability of device unknown
  • Costs of demand creation unknown and may contribute significantly to costs
conclusions
Conclusions
  • There is not significant cost differences per procedure for surgery only programs as compared to programs that used both surgery and Prepex device
  • The most important driver of costs is demand, as underutilization of sites leads to significant unit costs
  • Other cost drivers are supply chain management, commodities including device costs and staffing
  • Acceptability of devices as estimated by % of procedures performed using devices was not a significant driver of cost
acknowledgements
Acknowledgements
  • Co-investigators of the Modeling
    • Dr Katharine Kripke, HPI/Futures Institute
    • Dr Emmanuel Njeuhmeli, USAID
    • Dr. Dianna Edgil, USAID
    • Dr. Steven Forsythe, HPI/Futures Institute
    • Dr Delivette Castor, USAID
    • Juan Jaramillo, SCMS
  • Dr Jason Reed, OGAC
  • Dr Anne Thomas, DoD
  • Dr Renee Ridzon, Consultant BMGF
  • Tim Farley, Sigma 3 Services
  • Dr Dino Rech, CHAPS
  • Robert Bailey, University of Illinois
  • Walter Obiero, NRHS Kenya
  • Dr. Karin Hatzold, PSI
  • PSI, Jhpiego, FHI, SCMS, CHAPS
  • PrepPex study team Zimbabwe:
    • Prof. MufutaTshimanga, University of Zimbabwe
    • Dr. TonderaiMangwiro, University of Zimbabwe
    • Dr. Owen Mugurungi, Zimbabwe MOHCW
    • Sinokuthemba Xaba, Zimbabwe MOHCW
    • PessanaiChikobo, ZICHIRE